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Öğe Adropin: A New Marker for Predicting Late Saphenous Vein Graft Disease after Coronary Artery Bypass Grafting(Canadian Soc Clinical Investigation, 2014) Demircelik, Bora; Cakmak, Muzaffer; Nazli, Yunus; Gurel, Ozgul M.; Akkaya, Nermin; Cetin, Mustafa; Cetin, ZehraPurpose: Saphenous vein graft disease (SVGD), defined as an occlusion of 50% or more of the SVG excluding distal anastomotic occlusion, is an important predictor of morbidity after coronary artery bypass grafting (CABG). Late graft occlusion is a serious complication that often limits the use of the saphenous vein as a coronary bypass graft. Late graft occlusion is particularly common in old, degenerated venous grafts with advanced atherosclerotic plaques. Adropin has been implicated in the homeostatic control of metabolism. The purpose of this study was to investigate whether serum adropin levels are associated with late SVGD following CABG. Methods: Thirty-eight patients with SVGD involving at least one graft (occluded group; 14 females, 24 males) and 42 patients with a patent saphenous vein graft (patent group; 15 females, 27 males) were enrolled in this study. Venous blood samples were taken from all of the participants to measure plasma adropin levels using an enzyme-linked immunsorbent assay kit. Results: The mean adropin level was significantly lower in the occluded group than in the patent group (3.2 +/- 0.71 vs. 4.9 +/- 1.51 ng/ mL, p < 0.001). Multivariate regression analysis showed that the adropin level was the independent predictor of late saphenous vein graft occlusion. Conclusions: Adropin levels are lower in patients with late saphenous vein graft occlusion and these reduced adropin levels, together with other factors, may lead to saphenous vein graft occlusion. Larger and prospective studies are needed to determine if adropin plays a role in the pathogenesis of SVGD.Öğe Antiplatelet Effect of Sequential Administration of Cilostazol in Patients with Acetylsalycilic Acid Resistance(Taiwan Soc Cardiology, 2016) Cakmak, Muzaffer; Demircelik, Bora; Cetin, Mustafa; Cetin, Zehra; Isik, Serhat; Cicekcioglu, Hulya; Ulusoy, Feridun VasfiBackground: Acetylsalicylic acid (ASA) resistance in patients with coronary artery disease is an important medical problem that can affect treatment decision-making and outcomes. Cilostazol has been investigated to determine its effectiveness in patients with acetylsalicylic acid resistance. The aim of this study was to evaluate the antiplatelet efficacy of sequential administration of CLZ in patients with ASA resistance. Methods: A total of 180 patients were enrolled in our study. Patients with stable coronary artery disease were first given orally ASA 100 for 10 days, followed by collagen/epinephrine induced closure time (CTCEPI) measurements. Those who were found to be resistant to orally 100 mg of ASA were given orally 300 mg of ASA for an additional 10 days after which we repeated CTCEPI measurements. Those patients with resistance to orally 300 mg ASA were then given CLZ at a daily dose of orally 200 mg for 10 days followed by a final CTCEPI measurement. Results: The rate of resistance to 100 mg ASA was 81/180 (45%) compared to a rate of 35/81 (43.2%) with 300 mg ASA. Of the 35 patients found to be resistant to 300 mg ASA, 22 (62.9%) also failed to respond to CLZ treatment. Overall, sequential administration of 300 mg ASA and 200 mg CLZ resulted in a reduction in the number of non-responders from 45% to 12.2%. Conclusions: Initiation of CLZ could be of benefit in some patients with ASA-resistance for whom an effective anti-aggregant effect is of clinical importance.Öğe Antiplatelet Effect of Sequential Administration of Cilostazol in Patients with Asetylsalycilic Acid Resistance(Elsevier Science Inc, 2013) Demircelik, Muhammed Bora; Cetin, Mustafa; Cetin, Zehra Guven; Isik, Serhat; Sahin, Muslum; Kiziltunc, Emrullah; Cicekcioglu, Hulya[Abstract Not Available]Öğe Predictive Value of Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Patients with Coronary Slow Flow(Taiwan Soc Cardiology, 2016) Cetin, Mustafa; Kiziltunc, Emrullah; Elalmis, Ozgul Ucar; Cetin, Zehra Guven; Demircelik, Muhammed Bora; Cicekcioglu, Hulya; Kurtul, AlparslanBackground: Increased microvascular resistance due to chronic inflammation is assumed to be one of the mechanisms associated with coronary slow flow (CSF). Previous studies have shown that the platelet-to-lymphocyte ratio (PLR) and the neutrophil-lymphocyte ratio (NLR) are markers of inflammation for various diseases. In this study we aimed to evaluate the relationship between CSF and PLR-NLR. Methods: Seventy-eight patients with CSF and 50 patients with normal coronary flow were enrolled into this study. The study subjects underwent medical examination and testing, after which their platelet-to-lymphocyte ratios and NLR values were calculated. An independent observer measured the coronary flow rate by Thrombolysis in Myocardial Infarction Frame Count (TFC) method. The platelet-to-lymphocyte ratio and NLR values were compared between the groups and correlation analysis was performed to explore the relationship between mean TFC with PLR and NLR. Results: Platelet-to-lymphocyte ratio and NLR values were significantly higher in patients with CSF (p < 0.001). There was a positive significant correlation between TFC with NLR and PLR (Spearman's Rho: 0.59, p < 0.001 and Spearman's Rho: 0.30, p = 0.001, respectively). Multivariate logistic regression analysis revealed that NLR is the one independent predictor for CSF. Conclusions: This study demonstrated an association between CSF and PLR-NLR. Although the exact mechanism could not be explained, our findings support the possible role of inflammation in CSF physiopathology.Öğe The Effectiveness of Multimedia Nursing Education on Reducing Illness-Related Anxiety and Depression in Coronary Care Unit's Patients(Elsevier Science Inc, 2013) Demircelik, Muhammed Bora; Yigit, Derya; Sentepe, Esra; Keklik, Mevlude; Cetin, Mustafa; Cetin, Zehra; Eryonucu, Beyhan[Abstract Not Available]Öğe The Predictive Value of Intraventicular Dyssynchrony in Response to Levosimendan Therapy in Patients with Decompensated Heart Failure(Elsevier Science Inc, 2013) Cetin, Zehra Guven; Cetin, Mustafa; Sahin, Muslum; Kiziltunc, Emrullah; Demircelik, Muhammed Bora; Cicekcioglu, Hulya; Ucar, Ozgul[Abstract Not Available]Öğe The Relationship Between Adropin Levels and the Slow Coronary Flow Phenomenon(Springer India, 2015) Demircelik, Bora; Kurtul, Alparslan; Ocek, Hakan; Cakmak, Muzaffer; Cetin, Mustafa; Ureyen, Cagin; Eryonucu, BeyhanThere is accumulating evidence that inflammation plays a major role in the development of the slow coronary flow (CSF) phenomenon. In this study, we aimed to study the new biomarker adroin levels as it relates to CSF. Patients who underwent coronary angiography before and had no significant epicardial coronary disease were included in the study. Patients who had thrombolysis in myocardial infarction frame counts (TFCs) above the normal cutoffs were considered to have CSF and those within normal limits were considered to have normal coronary flow (NCF). NCF group over the age of 30 were selected from patients with normal coronary arteries. The adropin levels and biochemical profiles of all patients were studied and analyzed with coronary flow parameters. There were 58 patients in the CSF group and 50 patients in the NCF group. The mean adropin level was significantly lower in CSF group than in NCF group (3.2 +/- 0.71 vs. 4.9 +/- 1.51 ng/mL, p < 0.001). There was a significant correlation between the adropin levels and TFC (r = -0.676, p < 0.001). Multivariable regression analysis showed that the adropin levels were an independent predictor of the CSF phenomenon (odds ratio = 1.041, 95 % confidence interval: 1.004-1.114, p = 0.014). In this study, we show that patients with CSF have decreased levels of adropin. We further show a strong correlation between the adropin levels and coronary blood flow. We conclude that decreased adropin levels might be a useful tool in predicting CSF in patients who undergo coronary angiography.
